Horn D L, Opal S M, Lomastro E
Merck US Human Health, West Point, PA, USA.
Scand J Infect Dis Suppl. 1996;101:9-13.
Compelling experimental evidence now exists that antimicrobial agents induce the release of endotoxin from Gram-negative bacteria during the process of bacteriolysis. Different antimicrobial classes, particularly those which act upon the outer membrane of bacteria, vary in the amount of free endotoxin released from Gram-negative organisms. Despite this in vitro evidence, clinically important consequences of antibiotic-induced endotoxin release have yet to be consistently documented. Complexities in the host-pathogen interactions during actual infection with Gram-negative bacteria may account for the difficulties in demonstrating this phenomena in vivo. This brief review analyses these interactions and defines clinical settings where antibiotic-induced endotoxin release may prove to be clinically relevant.
目前已有令人信服的实验证据表明，抗菌剂在细菌溶解过程中会诱导革兰氏阴性菌释放内毒素。不同种类的抗菌剂，尤其是那些作用于细菌外膜的抗菌剂，从革兰氏阴性菌释放的游离内毒素量各不相同。尽管有这些体外实验证据，但抗生素诱导内毒素释放的临床重要后果尚未得到一致证实。在革兰氏阴性菌实际感染期间宿主与病原体相互作用的复杂性，可能是在体内证明这一现象存在困难的原因。本简要综述分析了这些相互作用，并确定了抗生素诱导内毒素释放可能具有临床相关性的临床情况。
